An Investigation of Organic Factors in the Neuropsychological Functioning of Patients with Borderline Personality Disorder

The hypothesis to be tested in this study was that the cognitive deficits that have been documented in patients with Borderline Personality Disorder (BPD) are largely the consequence of organic insult, either developmental or acquired. Using a cross–sectional design, 80 subjects (males and females) who met the criteria for BPD participated in the study. They completed a battery of neuropsychological tests and a comprehensive interview assessing organic status as well as measures of the potentially confounding factors of current levels of depression and anxiety. It was expected that BPD-patients with a probable history of organic insult would perform significantly worse than would BPD patients without such a history. Analyses of the results provided partial support for the hypothesis. Subjects with both BPD and a history of organic insult were significantly more impaired on several measures including measures of attention than were BPD only subjects. The results suggested that the impaired cognitive performance of persons diagnosed with BPD may, in part, be attributed to organic factors.

Quantitative fit assessment of a precontoured fracture fixation plate : its automation and an investigation on the borderline cases

Virtual methods to assess the fitting of a fracture fixation plate were proposed recently, however with limitations such as simplified fit criteria or manual data processing. This study aims to automate a fit analysis procedure using clinical-based criteria, and then to analyse the results further for borderline fit cases. Three dimensional (3D) models of 45 bones and of a precontoured distal tibial plate were utilized to assess the fitting of the plate automatically. A Matlab program was developed to automatically measure the shortest distance between the bone and the plate at three regions of interest and a plate-bone angle. The measured values including the fit assessment results were recorded in a spreadsheet as part of the batch-process routine. An automated fit analysis procedure will enable the processing of larger bone datasets in a significantly shorter time, which will provide more representative data of the target population for plate shape design and validation. As a result, better fitting plates can be manufactured and made available to surgeons, thereby reducing the risk and cost associated with complications or corrective procedures. This in turn, is expected to translate into improving patients' quality of life.

Managing Work, Hedonism and 'the Borderline' Between the Legal and Illegal Markets: Two Case Studies of Recreational Heavy Drug Users

In the context of cultural and/or differential ‘normalisation’ of certain forms of drug use, this article describes two case-studies of heavy recreational drug users. The daily lives of these users blur the line between the legal and the illegal; their drug trading is generally as a consumer and ‘friend of a friend’ small dealer in the low-level market. In the first case, problems with management of employment, time and financial budgeting are described; in the second case, such management is accomplished. Discussion refers to: differences between the two in relation to resources and vulnerability to risks, and to leisure/pleasure cultures of hedonism. The research agenda should pay more attention to users who seek to maintain a legitimate lifestyle but who develop problems managing work and their drug-related leisure. Understanding the consumer demand and dealing activity of such users is important in trying to develop a fuller understanding of drug markets.

A quantum probability perspective on borderline vagueness

The term “vagueness” describes a property of natural concepts, which normally have fuzzy boundaries, admit borderline cases, and are susceptible to Zeno’s sorites paradox. We will discuss the psychology of vagueness, especially experiments investigating the judgment of borderline cases and contradictions. In the theoretical part, we will propose a probabilistic model that describes the quantitative characteristics of the experimental finding and extends Alxatib’s and Pelletier’s (2011) theoretical analysis. The model is based on a Hopfield network for predicting truth values. Powerful as this classical perspective is, we show that it falls short of providing an adequate coverage of the relevant empirical results. In the final part, we will argue that a substan- tial modification of the analysis put forward by Alxatib and Pelletier and its probabilistic pendant is needed. The proposed modification replaces the standard notion of probabilities by quantum probabilities. The crucial phenomenon of borderline contradictions can be explained then as a quantum interference phenomenon.

Social work with marginalised people who have a mild or borderline intellectual disability : practicing gentleness and encouraging hope

People with mild or borderline intellectual disabilities are a group of people who usually do not meet the eligibility criteria for specialist disability services, yet are high users of many generalist services, such as mental health, child protection, and criminal justice systems. They may traverse many services, often entering, exiting, and returning to the same service providers with few positive results. This article explores the practice approach of the Meryton Association, a medium-sized nongovernment agency located in Brisbane, Australia. The Meryton Association provides social work support to people with mild to borderline intellectual disabilities, actively assisting this group to build relationships, resources, knowledge, and autonomy in their everyday lives. Using qualitative in-depth interviews with Meryton Association staff and secondary analysis of Meryton Association policy and practice documents, the challenges and opportunities of using this practice approach have been documented. The article proposes that specialist services are needed that use a developmental approach, stress the importance of relationship, and the need to practice gentleness and hope in social worker-client interaction.

An MRI study of pituitary volume and parasuicidal behavior in teenagers with first-presentation borderline personality disorder

This structural magnetic resonance imaging study examined the relationship between pituitary gland volume (PGV) and lifetime number of parasuicidal behaviors in a first-presentation, teenage borderline personality disorder (BPD) sample with minimal exposure to treatment. Hierarchical regression analysis revealed that age and number of parasuicidal behaviors were significant predictors of PGV. These findings indicate that parasuicidal behavior in BPD might be associated with greater activation of the hypothalamic-pituitary-adrenal (HPA) axis. Further studies are required using direct neuroendocrine measures and exploring other parameters of self-injurious behavior, such as recency of self-injurious behavior, intent to die and medical threat.

Pituitary volume in teenagers with first-presentation borderline personality disorder

This study used magnetic resonance imaging to examine pituitary gland volume (PGV) in teenage patients with a first presentation of borderline personality disorder (BPD). No difference in PGV was observed between healthy controls (n=20) and the total BPD cohort (n=20). However, within the BPD cohort, those exposed to childhood trauma (n=9) tended to have smaller pituitaries (-18%) than those with no history of childhood trauma (n=10). These preliminary findings suggest that exposure to childhood trauma, rather than BPD, per se, might be associated with reduced PGV, possibly reflecting hypothalamic-pituitary-adrenal axis dysfunction.

The relationship between personality characteristics and postconcussion symptoms in a non-clinical sample

Postconcussion symptoms are relatively common in the acute recovery period following mild traumatic brain injury (MTBI). However, for a small subset of patients, self reported postconcussion symptoms continue long after injury. Many factors have been proposed to account for the presence of persistent postconcussion symptoms. The influence of personality traits has been proposed as one explanation. The purpose of this study was to examine the relation between postconcussion-like symptom reporting and personality traits in a sample of 96 healthy participants. Participants completed the British Columbia Postconcussion Symptom Inventory (BC-PSI) and the Millon Clinical Multiaxial Inventory III (MCMI-III). There was a strong positive relation between the majority of MCMI-III scales and postconcussion-like symptom reporting. Approximately half of the sample met the International Classification of Diseases-10 Criterion C symptoms for Postconcussional Syndrome (PCS). Compared with those participants who did not meet this criterion, the PCS group had significant elevations on the negativistic, depression, major depression, dysthymia, anxiety, dependent, sadistic, somatic, and borderline scales of the MCMI-III. These findings support the hypothesis that personality traits can play a contributing role in self reported postconcussion-like symptoms.

Pathologising difference, governing personality

Recent research has stressed the integral part played by teachers in both preliminary diagnosis and ongoing treatment of a range of conduct and personality disorders. Teachers are not only required to be aware of a variety of new categories of difference (Attention Deficit Disorder, Selective Mutism, Borderline Personality Disorder, Antisocial Personality Disorder, to name but a few), but are also now lauded for extending the role of education into new areas of social management. This paper will take issue with this understanding on two counts: first, teachers have always sought to mould the personalities of students, and the pathologisation of specific forms of conduct is simply a new tactic within a very old and familiar strategy. Second, schools do not simply discover disorders such as ADD as objective facts of nature. Rather, they are part of the process through which such differences are created, and by which individuals can be more effectively governed.

A disordered approach

It seems a new behaviour disorder is identified every week. Forms of conduct once simply regarded as part of the human condition, are rapidly being reinterpreted as types of mental illness. Individuals are no longer simply quiet or shy, they are reclassified as suffering from Generalised Social Phobia, or Selective Mutism, or Avoidant Personality Disorder. Others are no longer simply unpopular or obnoxious, they are reclassified as Borderline Personality Disorder, or Antisocial Personality Disorder. Still more are no longer lively or boisterous, they have Attention Deficit Hyperactivity Disorder, or Conduct Disorder, or Oppositional Defiance Disorder.

Contracting bubbles in Hele-Shaw cells with a power-law fluid

The problem of bubble contraction in a Hele-Shaw cell is studied for the case in which the surrounding fluid is of power-law type. A small perturbation of the radially symmetric problem is first considered, focussing on the behaviour just before the bubble vanishes, it being found that for shear-thinning fluids the radially symmetric solution is stable, while for shear-thickening fluids the aspect ratio of the bubble boundary increases. The borderline (Newtonian) case considered previously is neutrally stable, the bubble boundary becoming elliptic in shape with the eccentricity of the ellipse depending on the initial data. Further light is shed on the bubble contraction problem by considering a long thin Hele-Shaw cell: for early times the leading-order behaviour is one-dimensional in this limit; however, as the bubble contracts its evolution is ultimately determined by the solution of a Wiener-Hopf problem, the transition between the long-thin limit and the extinction limit in which the bubble vanishes being described by what is in effect a similarity solution of the second kind. This same solution describes the generic (slit-like) extinction behaviour for shear-thickening fluids, the interface profiles that generalise the ellipses that characterise the Newtonian case being constructed by the Wiener-Hopf calculation.

Food insecurity among Australian children : potential determinants, health and developmental consequences

Children in food-insecure households may be at risk of poor health, developmental or behavioural problems. This study investigated the associations between food insecurity, potential determinants and health and developmental outcomes among children. Data on household food security, socio-demographic characteristics and children’s weight, health and behaviour were collected from households with children aged 3–17 years in socioeconomically disadvantaged suburbs by mail survey using proxy-parental reports (185 households). Data were analysed using logistic regression. Approximately one-in-three households (34%) were food insecure. Low household income was associated with an increased risk of food insecurity [odds ratio (OR), 16.20; 95% confidence interval (CI), 3.52–74.47]. Children with a parent born outside of Australia were less likely to experience food insecurity (OR, 0.42; 95% CI, 0.19–0.93). Children in food-insecure households were more likely to miss days from school or activities (OR, 3.52; 95% CI, 1.46–8.54) and were more likely to have borderline or atypical emotional symptoms (OR, 2.44; 95% CI, 1.11–5.38) or behavioural difficulties (OR, 2.35; 95% CI, 1.04–5.33). Food insecurity may be prevalent among socioeconomically disadvantaged households with children. The potential developmental consequences of food insecurity during childhood may result in serious adverse health and social implications.

A salutogenic approach to healing following child sexual assault

Decades of research has now produced a rich description of the destruction child sexual assault (CSA) can cause in an individual’s life. Post-Traumatic Stress Disorder (PTSD), Dissociative Identity Disorder, Borderline Personality Disorder, depression, anxiety, Panic Disorder, intimacy issues, substance abuse, self-harm, and suicidal ideation and attempts, are some of the negative outcomes that have been attributed to this type of traumatic experience. Psychology's tendency to dwell within a pathological paradigm, along with popular media who espouse a similar rhetoric, would lead to the belief that once exposed to CSA, an individual is forever at the mercy of dealing with a massive array of accompanying negative effects. While the possibility of these outcomes in those who have experienced CSA is not at all denied, it is also timely to consider an alternative paradigm that up until now has received a paucity of attention in the sexual assault literature. That is to say, not only do people have the ability to work through the painful and personal impacts of CSA, but for some people the process of recovery may provide a catalyst for positive life changes that have been termed post-traumatic growth (Tedeschi & Calhoun, 1995). To begin with in this chapter, the negative sequale’ of childhood sexual assault it discussed initially. Inherent to this discussion are questions of measurement and definitions of sexual assault. The chapter highlights ways in which the term CSA has been defined and hence operationalised in research, and the myriad problems, confusions, and inconclusive findings that have plagued the sexual assault literature. Following this is a review of the sparse literature that has conceptualised CSA from a more salutogenic (Antonovsky, 1979) theoretical orientation. It is argued that a salutogenic approach to intervention and to research in this area, provides a more useful way of promoting healing and the gaining of wisdom, but importantly does not negate the very real distress that may accompany growth. This chapter will then present a case study to elucidate the theoretical and empirical literature discussed using the words of a survivor. Finally, the chapter concludes with implications for therapeutic practice, which includes some practical ways in which to promote adaptation to life within the context of having survived this insidious crime.